What term describes passing the excess costs of care for one group onto another group?

What term describes passing the excess costs of care for one group onto another group?

• A. Data
• B. Cost-shifting
• C. Deductible
• D. Critical Pathway

Answer: (B)

Cost-shifting is the term for passing the excess costs of care for one group onto another group. In health care, this happens when underpayment from programs like Medicare or Medicaid, or high levels of uncompensated care, are offset by higher charges to private payers or higher premiums. Hospitals or providers may accept lower reimbursement from one payer group and raise prices for others to cover the shortfall, effectively moving the financial burden from one group to another. The other options don’t describe this phenomenon: data is information used for analysis; a deductible is what the patient pays before insurance starts paying; and a critical pathway is a standardized plan for delivering care.

Cost-shifting is the term for passing the excess costs of care for one group onto another group. In health care, this happens when underpayment from programs like Medicare or Medicaid, or high levels of uncompensated care, are offset by higher charges to private payers or higher premiums. Hospitals or providers may accept lower reimbursement from one payer group and raise prices for others to cover the shortfall, effectively moving the financial burden from one group to another. The other options don’t describe this phenomenon: data is information used for analysis; a deductible is what the patient pays before insurance starts paying; and a critical pathway is a standardized plan for delivering care.